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Turkiye Klinikleri Journal of Medical Sciences, vol.25, no.5, pp.706-723, 2005 (SCI-Expanded)
Nosocomial infections, potentially a problem of dire consequences for hospitalized patients and Healthcare staff, are discussed at length in this article, with emphasis on preventive measures and treatment modalities. Nosocomial infections often develop after hospitalization of patients with a history of infection. They most frequently manifest as urinary and surgical infections, bacteremia and pneumonia. In patients with hematological and oncological malignancies undergoing chemotherapy or radiotherapy, immunodeficiency is not uncommon and associated hospital infections may develop. Severe infections may also develop in patients subjected to immunosuppressive treatment, splenectomy and bone marrow transplantation. Isolation procedures play an important role in the control of hospital infections. Such procedures are customarily applied in two forms: disease-based isolation and category-based isolation. The latter includes full, contact, and respiratory isolation (e.g., Tbc), as well as drainage-secretion, blood and other body fluid containment measures. These practical measures are aimed at diminishing the risk of contamination through fluid- and airborne pathogens. It is emphasized that stringent procedures are to be applied under the tuberculosis control methods to avoid strengthening resistance to vancomycin in hospitalized patients. Intravascular catheters are often used for chemotherapy and fluid replacement, which frequently results in catheter-induced infections. The prevention and treatment of such infections are issues of importance. Another precaution is the use of HEPA filters that prevent air contamination in neutropenic patient rooms. Chemical products used for hand antisepsis in hospitals include alcohol, chlorohexidine, gluconate, hexachlorophene, iodine and iodophores, para-chloro-meta-xylenol and triclosan. A determination of the disinfection method to be employed is often possible when the potential risks of infection associated with the use of certain patient care materials in the hospital environment are considered. However, potential foci for daily disinfection procedures may be classified into three groups: the hospital floor in general, floors infected with blood and other patient materials, and surfaces such as desks and chairs. No special disinfectant is usually needed in the cleansing of regular hospital areas such as floors, walls, WC, bathroom and door handles that are regularly serviced and do not carry a heightened risk of infection. Copyright © 2005 by Türkiye Klinikleri.